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104-10115-10154 JFK Assassination Records Archives 1 (11/17/1970)

handle is hein.jfk/jfkarch10667 and id is 1 raw text is: 104.10115.1OV



















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                                                                         (Classify When Filled 1,
                             OUTSIDE ACTIVITY APPROVAL REQUEST
                   COMPLETE AND FORWARD ORIGINAL AND 3 COPIES TO EMPLOYEE ACTIVITY BRANCH
TO        DIRECTOR OF SECURITY; ATTN:   EMPLOYEE ACTIVITY BRANCH
THRU:    (Staff. division or office head and security officer, where assigned)
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        NAME AND GRADE OF EMPLOYEE (Print  r  COMPONENT      ROOM NO. AND BLDG. PHONE
FROM:                    AA Z
            1. ~~     ~      ~      ~    ~     1 FULL DESRIPIO OFOT-EATVTVO -I~ POVII rIFTnINI~t~ .r rA ~ A


CONCERNED. DATES. LOCALE. ETC. (Refer  to HR  10-7 before completing)
                      *awke  d         tduP        .

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2. REMARKS BY REOUESTOR  At&                            (6           W           .   .

        IN ENGAGING IN THE REQUESTED ACTIVITY,  I WILL MAKE NO REFERENCE TO OR DISCUSS
  MY CIA ASSIGNMENTS  OR DUTIES.  I (W1    WILL NOT)  BE IDENTIFIED AS EMPLOYED BY CIA
  FOR THE FOLLOWING  REASONS:




                                                          SIGNATURE OFtk OUESTING EMPLOYEE
3. COMMENTS AND CONCURRENCE OF STAFF. DIVISION OR OFFICE HEAD





                         CONCUR:-
                                        DATE              SIGNATURE OF OPERATING OFFICIAL
               FOR COMPLETION BY EMPLOYEE ACTIVITY BRANCH AND RETURN OF ORIGINAL TO EMPLOYEE

   DATE:                .  '70

   SECURITY APPROVAL HAS  BEEN (GRANTED, DENIED)
   FOR THE ACTIVITY CONTEMPLATED  BY THIS REQUEST.



   (FOR) CHIEF, PERSONNEL SECURITY DIVISION

  879          EVIOUS                                   '             CIA  INTERNAL USE ONL


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          CIA NTE~ --* N . .


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